Written by attorneys · grounded in primary & secondary sources — see below
A claim submitted to obtain benefits or compensation that rests on false representations or fabricated facts.
Sources & Authorities
How it applies
Common Examples
6
Paternity Support Deadline Challenge
Frank Fisher files a support action on behalf of his nonmarital child six years and one day after the child's birth. The state statute bars the suit to prevent stale or fraudulent claims, yet the court applies intermediate scrutiny and finds no substantial relation between the rigid cutoff and any proven risk of fabricated paternity assertions.
Guest Injury Claim in Tort Suit
Flora Ford, a New York guest injured in an Ontario accident, sues her host under New York negligence law. Ontario's guest statute, aimed at preventing fraudulent claims against local defendants and insurers, is considered but rejected because New York's interest in full compensation prevails.
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Cases
Restatements
Dictionaries
Schultz v. Boy Scouts of America, Inc.65 N.Y.2d 189, 491 N.Y.S.2d 90, 480 N.E.2d 679 (1985)
Illegitimate Heir Inheritance Petition
Farah Fox petitions to inherit from her deceased father without any lifetime paternity adjudication. The estate administrator raises concerns over fraudulent claims of heirship, and the court upholds the lifetime-establishment requirement as substantially related to orderly estate administration.
Lalli v. Lalli439 U.S. 259 (1978)
Unemployment Benefits Religious Objection
Fiona Foster refuses Saturday work on religious grounds and seeks unemployment compensation. The state agency worries that feigned religious objections could produce fraudulent claims that drain the fund, yet the court finds no demonstrated risk sufficient to justify denying benefits.
Sherbert v. Verner374 U.S. 398 (1963)
Lawyer Advertising and Claim Risk
Francisco Frost, an attorney, runs truthful advertisements about contingency-fee services. Opponents argue the ads will encourage fraudulent claims by clients, but the court finds no inevitable link between advertising and dishonesty that would justify a total ban.
O’Steen v. State Bar of Arizona433 U.S. 350, 97 S.Ct. 2691, 53 L.Ed.2d 810 (1977)
Conspiracy to Defraud Corporation
Felipe Figueroa and others agree to submit false invoices to a federally assisted electric cooperative. The government charges conspiracy to defraud the United States, and the court holds that using a third-party recipient satisfies the statute even without direct contact with federal officials.
Tanner v. United States483 U.S. 107 (1987)
Common questions
Frequently Asked
5
What constitutes a fraudulent claim in an insurance policy context?+
A claim is fraudulent when it rests on false representations about the occurrence or extent of a covered loss. Courts examine whether the policy language serves an evidentiary purpose that still prevents fabrication even if literal conditions are unmet.
Supporting sources
Why do states impose special proof requirements on nonmarital children seeking inheritance?+
States seek to reduce the risk of fraudulent claims of heirship that could disrupt estate administration. Requiring lifetime paternity adjudication supplies objective evidence that informal proof cannot reliably provide.
Supporting sources
When must a lawyer withdraw from representing a client asserting a fraudulent insurance claim?+
Withdrawal is required when the client persists in using the lawyer's services to further a fraud after the lawyer has explained the ethical limits. Continued negotiation on behalf of a staged-accident claim constitutes assistance in the fraud.
Supporting sources
Does a six-year cutoff for nonmarital children's support actions survive equal-protection review?+
No. The classification receives intermediate scrutiny and must be substantially related to preventing stale or fraudulent claims. A statute that allows marital children to sue indefinitely while barring nonmarital children after six years fails that test.
Supporting sources
How does common-law merger affect liability when conspirators complete an insurance-fraud scheme?+
Solicitation and attempt merge into the completed larceny, but conspiracy remains separately punishable. A defendant may therefore be convicted of both conspiracy and the completed offense.
Supporting sources
374 U.S. 398 (1963)Constitutional Law
…such abuse or danger has been advanced in the present case. The appellees suggest no more than a possibility that the filing of fraudulent claims by unscrupulous claimants feigning religious objections to Saturday work might not only dilute the unemployment compensation fund but also hinder the scheduling by employers of necessary…